2016-2017 AWANA Financial Assistance Application

Please answer questions fully and in their entirety. Incomplete applications will not be considered.

Submitting this application does not guarantee you will receive a scholarship and/or financial assistance. Scholarships/assistance is needs-based and subject to availability. Answers are kept confidential and only reviewed by those who will make the final determination of scholarships/assistance provided.

Question Title

Parent/Guardian Information

Full Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

How often do you attend Heritage Church?

Weekly

A Couple Times a Month

Every So Often

I Do Not Attend Heritage Church

Question Title

If you attend Heritage, which campus do you attend?

Bettendorf

Rock Island

Vida Nueva

Question Title

What areas of ministry are you involved with at Heritage?

Question Title

Child(ren)'s Information

Child's Name:

Date of Birth:

Child's Name:

Date of Birth:

Child's Name:

Date of Birth:

Child's Name:

Date of Birth: